I'm a cardiologist. As for Gary Hall (and other diabetics), I believe that insulin is performance-enhancing only to the extent that it keeps him alive, replacing what his pancreas can no longer provide.

Cheating in Athletics

You are right. Insulin (IFG1), Human Growth Hormone, THG (The Cream), EPO....... They were all mentioned as having tremendous affects on performance.

Dead Fish..... I am the Good Smith because Paul Smith is the Evil Smith who beats me in my prized 50 freestyle.

Gull80..... honestly...... tell us more about Insulin if you are a doctor and leave Gary and diabetics out of it. Are you familiar with the positive effects of non diabetic athletes who use it to grow muscle strength..... i.e to cheat?

IGF and insulin is not the same drug.
IGF Is "insulin like"
However insulin is highly anabolic.
Have none of you heard of Sir Roger Bannister?
Being a type I didnít set him back much.
And that was in 1954.. treatment has come along way.

John, I think you need to differentiate the use of insulin in a Type I diabetic from a nondiabetic (say an athlete trying to gain some benefit) with normal insulin production. Type I diabetics under ordinary circumstances have difficulty regulating their blood sugars; Gary is training at an elite level, consequently the process is several orders of magnitude more complex. Mistakes can be disastrous (hypoglycemia leading to convulsions vs. hyperglycemia resulting in ketoacidosis). Suggesting that he can achieve a performance enhancing benefit (other than staying alive) from insulin indicates a lack of understanding of the disease.

Multiple reply

Gull 80.... I am fully aware of the effects of diabetes. My mother is Type II.

My question to you was on non diabetics athletes use of insulin as well.

Geochuck...... wake up and smell the coffee dude. I suppose you think Flo Jo died of natural causes and Michelle Smith's urine was spiked by someone out to get her and cycling is a EPO clean.
Dude.... Victor is the real thing and he was way ahead of the agencies that test for drugs.

Michelle Smith was a NO ONE swimmer in Houston....then became the Gold Medal winner at the Olympics....Heck, from the looks of her pictures shortly before the Olympic Games they should have changed its name to Michael Smith.....and the fraud should give the medal back....IT WAS A CHEATER TO THE MAX THERE....

Re: Multiple reply

Originally posted by TheGoodSmith Geochuck...... wake up and smell the coffee dude. I suppose you think Flo Jo died of natural causes and Michelle Smith's urine was spiked by someone out to get her and cycling is a EPO clean. John Smith

Thanks the Tim Hortins Coffee is great, Thats right Flo Jo is not around, and just like Michelle Smith's explanation was the same as Ben Johnson, his drink was spiked. However testing for drugs etc in USA is very lax and if you use in the USA you will never be caught.

I believe many elite athletes have used performance enhancing drugs and most haven't been caught. They are driven by the mind set to succeed at any cost and since everyone is doing it, they should too.

In pro sports like baseball and football, there's a slight difference between being the best and being really great, but there's a gigantic difference in pay.

I met a fellow who was a pro cyclist in the late 1980's / early 1990's and I asked him,
"What percent of cyclists are dirty?"
He said, "All of them."

Gary is more different than most, because he is slightly imperfect. His beta-cells no longer secrete insulin. Watching his blood sugar levels rise and fall with training and racing provides a window into his physiologic needs for fuel, and an understanding of the intense stress athletes face when they compete. Working with Gary has taught me how to treat all of my patients who exercise, whether it is by walking around the block in the evenings or training for and competing in triathalons. The same rules apply.
The most important principle I learned is that every rule can be wrong in a given individual. I thought I knew about exercise, that training would make muscles more sensitive to glucose and lower insulin requirements. It made sense. But in Gary's case, that rule doesn't always apply. When he trains intensely he needs more insulin, largely because his carbohydrate intake is so high at 4,000 to 5,000 calories per day, with 60% or so of his calories coming from carbohydrate. When he's training less hard, his caloric intake and percentage carbohydrate ingestion is markedly reduced. So his insulin requirements are less. Another reason his insulin requirements are higher during his intense training sessions is because of the catecholamine response to such heavy training. As a sprinter he doesn't do lots of slow long distance swimming; he does more intense episodes of training, which may be more physiologically stressful.
Gary's insulin requirements change if he is training once a day or twice a day or three times a day. They differ if he is doing more weight training than cardio or the other way around. Time spent training in the pool is different than time spent training on land. Calculating doses wrong and he's too low at night, a delayed effect of training, but giving too little insulin overnight results in fasting hyperglycemia and a bad workout the next day. An insulin pump might offer the fine tuning of basal rates that would better match his physiologic needs, but as a swimmer Gary can't stand the drag of the tape and infusion site on his skin against the water. So he has become a master at adjusting his insulin doses, using a multiple daily insulin injection regimen that is more complex and varied than almost any other patient I treat.
Most of the time this approach works; the frequent insulin dosing and the 10 or more times he tests his blood sugar levels each day keep his sugars under control and his A1C level less than 7%. Sometimes, as with all patients, it doesn't work as well and hopefully that doesn't coincide with race days. I wish it were easier to manage our patients with type 1 diabetes, but it isn't, not yet. Gary, like all my patients with diabetes, dreams of the day this disease is cured. I dream along with them...I'd like to be out of a job, at least a job of treating blood sugar levels.